Missouri Public Health Organizations Urge Voters to Reject Both Tobacco Ballot Measures in November

JEFFERSON CITY, Mo., October 3, 2016 – Two tobacco measures will appear on the Missouri ballot in November: Amendment 3 and Proposition A. Both ballot initiatives are supported by the tobacco industry in an effort to deceive Missouri voters and prevent an adequate increase of Missouri’s lowest-in-the-nation tobacco tax. As a result, the American Cancer Society Cancer Action Network, the American Heart Association, American Lung Association in Missouri, Campaign for Tobacco-Free Kids, Health Care Foundation of Greater Kansas City and Tobacco-Free Missouri issue the following statement: “It is unfortunate two tobacco industry-sponsored ballot measures will appear on Missouri’s ballot in November. Voters should be alarmed that those who profit from keeping smokers addicted have hijacked worthwhile causes by forcing Missourians to settle for a paltry increase in the tobacco tax that will not deter smoking. “Small and incremental increases to the tobacco tax will not keep kids from becoming addicted to cigarettes or help adults quit. Tobacco taxes work when the price increase is substantial enough to motivate current smokers to quit and prevent kids from starting. A dime here or there is not sufficient. Tobacco companies are experts at finding ways to absorb small tax increases through adjusted pricing. “All previous efforts to raise Missouri’s tobacco tax by meaningful amounts have been thwarted by those who profit from smoking addiction – both convenience stores and cigarette manufacturers. R.J. Reynolds’ current campaign contributions totaling more than $5 million in support of a tobacco tax proposal are unprecedented. Reynolds, best known for their infamous Joe Camel cartoon, is notorious for its aggressive efforts to lure kids into smoking. Missouri voters shouldn’t let the tobacco industry write policies that ultimately keep our state’s youth hooked on these deadly products. “Tobacco products in Missouri are too cheap, and the health costs are too high. Our state is long overdue for a tobacco tax increase, but it needs to be one that will make a difference and save lives. “When it comes to Amendment 3 and Proposition A, we encourage Missouri voters to question motives and follow the money, which leads directly to the tobacco industry.”

Comprehensive tobacco cessation programs help smokers quit and ultimately save lives and money. By reducing tobacco use, they play a crucial role in the prevention of many chronic conditions such as cancer, heart disease, and respiratory illness. State tobacco control programs have been measured to have a $5 return for every $1 invested.

Advocates are disappointed by this missed opportunity as the Governor’s own 2015 budget recommendations included new funding for tobacco cessation. The General Assembly’s truly agreed to and finally passed 2015 budget included $150,000 in new state general revenue for tobacco cessation with a federal match of $150,000 for a total of $300,000 to the Department of Health & Senior Services.

However, the governor’s line item veto puts Missouri back to zero state funding for tobacco cessation and continues the toll of tobacco on Missourian’s health and wallet. Unfortunately, Missouri ranks 50th in spending for tobacco prevention and cessation, which has significant consequences including:

One of the highest state smoking rates: 23.9% national rate 19.1%

Annual Smoking Attributable Deaths in Missouri: 9,584

Annual Costs to the Missouri Economy Due to Smoking:

$2.13 billion health care costs

$532 million in state Medicaid expenditures

$584 paid by every household in Missouri from smoking-caused government expenditures.

“Research shows the majority of current smokers want to quit,” explains Traci Kennedy, Director of Tobacco Free Missouri, “It is essential to provide resources to help Missourians overcome this addiction to live healthier lifestyles.”

March 12, 2014 – Tobacco Free Missouri (TFM) joined health organizations and associations urging Missouri legislators to pass legislation that would protect state budget resources and result in raised prices for tobacco companies that sell cheap discount cigarettes.

The legislation, HB 1242 (sponsored by Reps. Rick Stream and Chris Kelly) and SB 820 (sponsored by Sen. Kurt Schaefer), would close a current loophole within the Master Settlement Agreement (MSA). By closing the loophole, millions of dollars in Missouri revenue could go towards programs such as health care for low-income Missourians (Medicaid), education and tobacco cessation. In addition, the change would result in smaller, discount tobacco companies increasing the price of their cigarettes. Missouri is the only state that participated in the 1998 MSA that has failed to close this loophole for nonparticipating manufactures.

“We support legislative changes that would force discount tobacco companies to raise their prices because higher cigarette prices discourage smoking, particularly for younger people,” said Traci Kennedy, Director of TFM. “The higher the prices, the harder to get hooked on cigarettes.”

In accordance with the MSA, tobacco companies are required to pay into an escrow account each year. Monies paid into this account were awarded to the states as retribution for the costs associated with smoking related death and disease. The problem in Missouri is that funds paid in by smaller tobacco companies, are released back to the companies. It is imperative that Missouri comply with the standards set by the MSA or be in jeopardy of losing the $130 million received each year. Thus far, the state has failed to invest these dollars in tobacco prevention and cessation. Legislators have the opportunity to close the loophole and commit to investing in the health of Missourians.

January 30, 2014 – Columbia, MO – Missouri is falling behind when it comes to funding efforts to reduce tobacco use through proven tobacco prevention and cessation programs. The U.S. Centers for Disease Control and Prevention (CDC) released Best Practices for Comprehensive Tobacco Control Programs—2014, an evidence-based guide to help states plan and establish programs to reduce tobacco use, including recommended funding levels for tobacco prevention and cessation efforts.

The CDC recommends that Missouri invest a minimum of $50 million on tobacco control programs. Last year the state dedicated just $76,000 to help prevent young people from starting to use tobacco and help those already addicted to quit. Meanwhile, Missourians’ addiction to nicotine is costing taxpayers $2.13 billion in annual health care costs related to smoking. The state tobacco tax is the lowest in the nation at $0.17.

“Evidence continues to show that investing in tobacco prevention saves lives and money. This is responsible fiscal policy that guarantees a positive return on investment,” said Traci Kennedy, director of Tobacco Free Missouri. “Helping current smokers quit and preventing young people from ever starting prepares Missouri for a brighter future by reducing the costs of death and disease that currently plague our state.”

Missouri has made positive steps recently in the fight against tobacco with 25 communities protecting employees from secondhand smoke in the workplace through comprehensive smokefree laws. Yet, use of this toxic and addictive product is still the number one preventable cause of death in the country and in the state. Research shows there are proven, effective ways to reduce tobacco’s toll by regularly and significantly increasing the price of tobacco, passing comprehensive smoke-free laws and adequately funding tobacco prevention and cessation programs.

Investing in these programs can create real change in Missouri. Fewer young people are picking up the habit with the high school and middle school smoking rates dropping 4.0% and 14.9% respectively between 2009 – 2013. With 63% of current smokers intending to quit in the next six months, support for the Missouri Quitline including nicotine replacement therapy like patches and gum, would greatly serve the state.

January 11th marks the 50th anniversary of the first Surgeon General’s report on Smoking and Health. (Read article). The 1964 report was the first official evidence that smoking causes lung cancer. All this week, TFM will celebrate the landmark report on Facebook and Twitter. Follow along with #SGR50.

11/20/2013 – Fewer teens are smoking in Missouri, but exposure to secondhand smoke is still a cause for concern, according to new data from the Missouri Department of Health and Senior Services (MO DHSS).

In the latest survey of Missouri middle and high school students’ health behaviors, MO DHSS found the rate of current smoking among middle students declined by more than half in that last decade, down from nearly 9 percent in 2003 to 4 percent in 2013. The survey also found a big change in the percentage of high school students who smoked. In 2013, about 15 percent of high school students reported currently smoking cigarettes. This reflects an almost 10 percent decrease since 2003 when nearly a quarter of high school students smoked.

The data, recently shared at Tobacco Free Missouri’s Annual Meeting, was encouraging news for tobacco control advocates and confirmation of the value of tobacco control efforts, particularly for young people.

“We know the tobacco industry is working hard to recruit Missouri youth to become life-long smokers,” said Tobacco Free Missouri Executive Director Traci Kennedy. “Through education, policy change and investment from statewide partners, we are happy to see that Missouri youth smoking rates are declining.”

While the specific reasons for the declines among youth are unknown, the decrease could be due to the changing views of smokefree policies among Missourians. Data also presented at the annual meeting showed support for smokefree policies in Missouri increased by 33 percent between 2007 and 2013. Today almost three in four Missourians support smokefree policies.

However, health advocates warn there are still strides to make in clearing the air. Findings from the student survey also showed that while fewer young people are smoking, about one in three middle school students and over half of all high school students were exposed to secondhand smoke in that last seven days.

Said Kennedy, “These data are concerning because adults and young people exposed to secondhand smoke are at an increased risk for a range of serious health problems such as asthma, bronchitis, and lung and heart disease. In Missouri, secondhand smoke causes 1,150 deaths per year, that’s over three people every day.”

11/19/13–Missourians across the state will help mark the Great American Smokeout this Thursday. Quitting smoking for even one day can help to improve health immediately. In just 20 minutes from quitting, a smoker’s heart rate and blood pressure drops, and after 12 hours, the carbon monoxide in a smoker’s blood drops to normal. Want to learn more? Visit the American Cancer Society (ACS) or join the conversation on Twitter and Facebook using the hashtag #quitforgood. On Wednesday, November 20th and Thursday, November 21, Sharecare & the American Cancer Society will host a Great American Smokeout Twitter Chat from 10 a.m. to 3 p.m. CST.

According to ACS, tobacco use remains the single largest preventable cause of disease and premature death in the US, yet about 43.8 million Americans still smoke cigarettes. That’s nearly one out of five adults in the U.S.

10/16/13–A recent decision from a three-judge panel between the tobacco companies and the states means an estimated $70 million loss for Missouri. Missouri has the lowest tobacco tax in the nation, and according to data from the Missouri Department of Health and Senior Services, 25 percent of Missouri adults and over 18 percent of high school students smoke.

Recognizing the high costs of treating tobacco-related disease, a critical public health agreement came from the 1998 Master Settlement Agreement between the tobacco companies and states. Under this agreement, Missouri has received more than $130 million each year since 2002. Attorney General Chris Koster appealed to state legislators to pass legislation that would address a loophole in the agreement, but the legislature did not act on these requests. In September, a three-judge panel ruled that Missouri failed to “diligently enforce tobacco laws in 2003” and the state will lose an estimated $70 million.

Colorado implemented a smokefree policy in 2006 making all workplaces and public places except casinos smokefree. During that time ambulance calls originating from everywhere but casinos dropped 20 percent; calls from casinos did not change. In 2008, when the Colorado policy was extended to include casinos, ambulance calls originating from casinos dropped by 20 percent immediately following implementation.

“This study again confirms prior medical findings that the dangers of secondhand smoke are very real; there is no safe level of exposure to secondhand smoke,” said Tobacco Free Missouri Executive Director Traci Kennedy. “This study clearly shows that smokefree policies work. Casino, bar, restaurant and other hospitality employees face serious health risks when there are no smokefree policies in place. Exempting casinos from these policies only means more Missourians will continue to face preventable medical emergencies and limited taxpayers’ dollars will continue to be stretched.”

Currently, only 20 states include state-regulated commercial casinos in their smokefree workplace laws. However, nearly 90 percent of casino workers are still exposed to secondhand smoke in their workplaces.

Each year, smoking causes nearly six million tobacco-related deaths worldwide. While tobacco use in Missouri is decreasing, it remains a problem. According to the Missouri Department of Health and Senior Services, in 2011, a quarter of Missouri adults smoked, the ninth highest rate in the country. An estimated 1,150 Missourians are killed due to secondhand smoke each year.